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Title: Prediction of olanzapine exposure in individual patients using physiologically based pharmacokinetic modelling and simulation
Authors: Thomas M. Polasek
Geoffrey T. Tucker
Michael J. Sorich
Michael D. Wiese
Titus Mohan
Amin Rostami-Hodjegan
Porntipa Korprasertthaworn
Vidya Perera
Andrew Rowland
Certara USA, Inc.
Certara, United Kingdom
University of South Australia
Flinders Medical Centre
Flinders University
Mahidol University
University of Manchester
Bristol-Myers Squibb
University of Sheffield
Keywords: Medicine;Pharmacology, Toxicology and Pharmaceutics
Issue Date: 1-Mar-2018
Citation: British Journal of Clinical Pharmacology. Vol.84, No.3 (2018), 462-476
Abstract: © 2017 The British Pharmacological Society Aim: The aim of the present study was to predict olanzapine (OLZ) exposure in individual patients using physiologically based pharmacokinetic modelling and simulation (PBPK M&S). Methods: A ‘bottom-up’ PBPK model for OLZ was constructed in Simcyp® (V14.1) and validated against pharmacokinetic studies and data from therapeutic drug monitoring (TDM). The physiological, demographic and genetic attributes of the ‘healthy volunteer population’ file in Simcyp® were then individualized to create ‘virtual twins’ of 14 patients. The predicted systemic exposure of OLZ in virtual twins was compared with measured concentration in corresponding patients. Predicted exposures were used to calculate a hypothetical decrease in exposure variability after OLZ dose adjustment. Results: The pharmacokinetic parameters of OLZ from single-dose studies were accurately predicted in healthy Caucasians [mean-fold errors (MFEs) ranged from 0.68 to 1.14], healthy Chinese (MFEs 0.82 to 1.18) and geriatric Caucasians (MFEs 0.55 to 1.30). Cumulative frequency plots of trough OLZ concentration were comparable between the virtual population and patients in a TDM database. After creating virtual twins in Simcyp®, the R2 values for predicted vs. observed trough OLZ concentrations were 0.833 for the full cohort of 14 patients and 0.884 for the 7 patients who had additional cytochrome P450 2C8 genotyping. The variability in OLZ exposure following hypothetical dose adjustment guided by PBPK M&S was twofold lower compared with a fixed-dose regimen – coefficient of variation values were 0.18 and 0.37, respectively. Conclusions: Olanzapine exposure in individual patients was predicted using PBPK M&S. Repurposing of available PBPK M&S platforms is an option for model-informed precision dosing and requires further study to examine clinical potential.
ISSN: 13652125
Appears in Collections:Scopus 2018

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